Cardiology Fellowships: Urban Community Program

Program Design: Cabrini Medical Center

Cabrini Medical Center is a 493-bed medical-surgical hospital located in lower Manhattan and serving areas of mid-Manhattan and the Lower East Side. It offers a broad array of clinical services from primary to tertiary care including specialized services in geriatrics, oncology, diabetes, wound care and AIDS. It has long been an academic institution but its history with Mount Sinai School of Medicine only dates from 1995. In that short time, however, it has proven its capabilities in the teaching and training of Mount Sinai medical students, expanding its role to highly sought after positions in all 4 years and full clerkships.

CC/CICU

There are approximately 200 patients with acute coronary syndromes admitted to the eight-bed CCU each year. Temporary pacemakers, arterial lines, right heart catheters and intraaortic balloon pump support are all available. These patients progress to the nine-bed Coronary Intermediate Care Unit. A cardiologist conducts cardiology rounds daily; however, the fellow does not make rounds and is only needed for procedures or complex clinical issues. For procedures, an assigned cardiologist with expertise and skill in the particular modality provides supervision, permitting greater independence as the fellow acquires increasing sophistication and skill (but there is still full review of all studies by the faculty member with the fellow). During special procedures (usually invasive), the cardiologist is always present throughout the procedure to provide overall guidance and supervision. These special procedures include right heart catheterization, intra-aortic balloon counterpulsation, temporary and permanent pacemaker implantation and transesophageal echocardiography. Patients requiring additional resources or support are often transferred to Mount Sinai Hospital.

Echocardiography Laboratory

Annually, there are approximately 2,000 transthoracic echocardiograms, 180 transesophageal echocardiograms and 175 stress and pharmacologic echocardiograms performed. A faculty member is assigned to review all studies at a daily review session. The Laboratory also provides full Vascular Ultrasound evaluations. Fellows have extensive opportunity to perform transthoracic studies with assistance from a technologist.

Nuclear Cardiology and Stress Laboratory

There are approximately 250 nuclear perfusion studies and 120 ECG treadmill tests (without imaging) done each year. All studies are reviewed by Cardiology and Nuclear Medicine faculty members. Plans are underway for the purchase of a new camera.